The burden and trend of diseases and their risk factors in Australia, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
Authors: Sheikh Mohammed Shariful Islam, Ralph Maddison, Riaz Uddin, Kylie Ball, Katherine M Livingstone, Asaduzzaman Khan, Jo Salmon, Ilana N Ackerman, Tim Adair, Oyelola A Adegboye, Zanfina Ademi, Ripon Kumar Adhikary, Bright Opoku Ahinkorah, Khurshid Alam, Kefyalew Addis Alene, Sheikh Mohammad Alif, Azmeraw T Amare, Edward Kwabena Ameyaw, Leopold N Aminde, Deanna Anderlini, Blake Angell, Adnan Ansar, Benny Antony, Anayochukwu Edward Anyasodor, Victoria Kiriaki Arnet, Thomas Astell-Burt, Prince Atorkey, Mamaru Ayenew Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Nasser Bagheri, Anthony Barnett, Bernhard T Baune, Dinesh Bhandari, Sonu Bhaskar, Raaj Kishore Biswas, Rohan Borschmann, Soufiane Boufous, Andrew M Briggs, Rachelle Buchbinder, Norma B Bulamu, Richard A Burns, Andre F Carvalho, Ester Cerin, Nicolas Cherbuin, Enayet Karim Chowdhury, Liliana G Ciobanu, Scott Richard Clark, Marita Cross, Abel Fekadu Dadi, Barbora de Courten, Diego De Leo, Katie de Luca, Kerrie E Doyle, David Edvardsson, Kristina Edvardsson, Ferry Efendi, Aklilu Endalamaw, Nelsensius Klau Fauk, Xiaoqi Feng, Bernadette Mary Fitzgibbon, Joanne Flavel, Eyob Alemayehu Alemayehu Gebreyohannes, Hailay Abrha Gesesew, Tiffany K Gill, Myron Anthony Godinho, Bhawna Gupta, Vivek Kumar Gupta, Mitiku Teshome Hambisa, Mohammad Hamiduzzaman, Graeme J Hankey, Hossein Hassanian-Moghaddam, Simon I Hay, Jeffrey J Hebert, M Mamun Huda, Tanvir M Huda, M Mofizul Islam, Mohammad Saidul Islam, Rakibul M Islam, Billingsley Kaambwa, Himal Kandel, Gizat M Kassie, Jaimon Terence Kelly, Jessica A Kerr, Girmay Tsegay Kiross, Luke D Knibbs, Vishnutheertha Vishnutheertha Kulkarni, Ratilal Lalloo, Long Khanh Dao Le, James Leigh, Janni Leung, Shanshan Li, Rashidul Alam Mahumud, Abdullah A Mamun, Melvin Barrientos Marzan, John J McGrath, Max L Mehlman, Atte Meretoja, Amanual Getnet Mersha, Ted R Miller, Philip B Mitchell, Ali H Mokdad, Lidia Morawska, Christine Mpundu-Kaambwa, William Mude, Christopher J L Murray, Sandhya Neupane Kandel, Tafadzwa Nyanhanda, Kehinde O Obamiro, Amy E Peden, Konrad Pesudovs, Kevan R Polkinghorne, Azizur Rahman, Muhammad Aziz Rahman, Zubair Ahmed Ratan, Lal Rawal, Lennart Reifels, Andre M N Renzaho, Stephen R Robinson, Danial Roshandel, Susan Fred Rumisha, Paul A Saunders, Susan M Sawyer, Markus P Schlaich, Aletta Elisabeth Schutte, Abdul-Aziz Seidu, Saurab Sharma, Seyed Afshin Shorofi, Soraya Siabani, Ambrish Singh, Balbir Bagicha Singh, Helen Slater, Jacqueline H Stephens, Mark A Stokes, Narayan Subedi Subedi, Chandra Datta Sumi, Jing Sun, Johan Sundström, Cassandra E I Szoeke, Santosh Kumar Tadakamadla, Ken Takahashi, Jo Taylor, Melkamu B Tessema Tessema, Amanda G Thrift, Quyen G To, Daniel Nigusse Tollosa, Mai Thi Ngoc Tran, Corneel Vandelanotte, Blesson Mathew Varghese, Lennert J Veerman, Ning Wang, Paul Ward, Mark Woodward, Befikadu Legesse Wubishet, Xiaoyue Xu, Pengpeng Ye, Sojib Bin Zaman, Amin Zarghami, Jianrong Zhang, David A Crawford
Journal: The Lancet Public Health (2023)

A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019.In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other high-income countries were made.Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9-77·1) in 1990 to 82·9 years (82·7-83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1-641·3) to 389·2 deaths (381·4-397·6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4-91·9) of total deaths, followed by injuries (5·7%, 5·3-6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9-3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5-28·1). Relative to similar countries, Australia's ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019.An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing.Bill & Melinda Gates Foundation.